This bill modifies how Medicare pays for cancer and complex therapies by requiring drug manufacturers to pay rebates when their prices exceed negotiated maximum fair prices. Under the legislation, manufacturers must rebate the difference between what Medicare would normally pay under the standard formula (ASP+6 percent) and what is owed under the negotiated price (MFP+6 percent), calculated quarterly based on the number of units dispensed. Patient cost-sharing would be reduced and based on the negotiated price rather than the standard formula, potentially lowering out-of-pocket expenses for beneficiaries receiving these drugs. The rebate amounts would be deposited into Medicare's trust fund, and manufacturers must provide rebates within 30 days of receiving quarterly usage data from the Secretary of Health and Human Services. The bill applies to drugs that are subject to Medicare's drug price negotiation program and includes penalties for manufacturers who fail to comply with the rebate requirements.